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CMS has recently posted the proposed revisions to the hospital-based hospice costs report. Click here to see them.

Last month, CMS published notice in the Federal Register that proposed revisions to the Hospital/Hospital Health Care Complex Cost Report will be made available for review, and provided a 60-day period for submission of public comments on the changes. Once the 60-day comment period closes, it is expected that the agency will announce a second, 30-day public comment period. CMS is now determining whether to extend its comment period, which is scheduled to remain open until April 7.

NAHC and its affiliate, the Hospice Association of America (HAA) is planning to submit comments on the proposed revisions.

CMS has been revising cost reporting requirements for hospices in an effort to secure more detailed data from hospice programs to support payment reform. The first set of revisions (applicable to freestanding hospices) greatly expanded reporting requirements and became effective with cost reporting years beginning on or after October 1, 2014.

Once CMS reviews the public comments, it will issue final revisions to the Hospital/Hospital Health Care Complex Cost Report as a regulatory transmittal. The comment process is expected to take a minimum of three months.

The Medicare Payment Advisory (MedPAC) has recently been examining concerns related to hospitals’ increased use of “observation status” in response to Recovery Audit Contractors (RAC) reviews of appropriateness of use of short-term inpatient stays. MedPAC plans to develop new recommendations to ease tensions between hospitals and RACs relative to short-stay hospital admission policies. MedPAC is also looking at policies that would yield savings to offset the cost of the recommendations. One option is to include hospice in the post-acute hospital transfer policy. MedPAC estimates that hospitals currently have an 88 percent financial margin on patients that are discharged “early” to hospice. If a post-hospital transfer policy were to be applied to early discharges to hospice, MedPAC estimates that hospital financial margins on short-stay patients discharged to hospital would be about 31 percent. NAHC has expressed concerns regarding the inclusion of hospice in the post-acute hospital transfer policy and believe it could have a negative impact on hospice patients and the Medicare program.

NAHC is seeking input from its hospice member organizations on this issue. If you have comments about the potential impact that inclusion of hospice in Medicare’s post-acute transfer policy could have on hospices, their patients, or the Medicare program generally, please email to NAHC by COB March 3, 2015.

Click here for more information from NAHC, including contact information.

Report: Healthcare System Fully Prepared To Handle Increased Coverage

According to a new report from The Commonwealth Fund, increased insurance coverage under the Affordable Care Act is unlikely to overwhelm healthcare services despite earlier research indicating the contrary. The report found that outpatient and inpatient hospital visits will increase by about 2.5 and 3 percent nationwide and that prescription medication use and refills will rise 2.5 percent in nearly every state. Despite these increases, the healthcare system is “likely to be able to absorb these increases.” Additionally, widespread adoption of technological advances is likely to further blunt the impact of increased use of services.

Several States No Longer Plan On Expanding Medicaid

Several states are now leaning toward or have outright abandoned all plans to allow expansion of their Medicaid programs. Most recently, Wyoming rejected plans to expand its Medicaid program via provisions offered under the Affordable Care Act. Representatives for Kansas have also told reporters that the state is not planning on scheduling hearings on three different bills allowing for Medicaid expansion. So far, 29 states have formally adopted Medicaid expansion, while the rest have either rejected adoption or are still considering it. Medicaid program enrollment has been growing exponentially under the new health law. The Obama administration announced that more than 10 million Americans have joined the Medicaid program since 2013.